title: Soft coagulation in partial nephrectomy without renorrhaphy: feasibility of a new technique and early outcomes.
abstract: OBJECTIVE
  To study the feasibility of a new partial nephrectomy technique using soft coagulation without renorrhaphy.
  
  
  METHODS
  Open partial nephrectomy using soft coagulation without renorrhaphy was carried out on 39 consecutive patients with renal tumors. The renal artery was clamped in the initial 23 cases (59%), whereas 16 surgeries (41%) were carried out without clamping. The resected surface of the kidney was coagulated solely by soft coagulation without renorrhaphy. Suturing was used only when the urinary collecting system was opened. The surgical results and perioperative complications were retrospectively evaluated.
  
  
  RESULTS
  The mean age of patients was 63.1 years. The mean tumor size was 28.2 mm (range 10-56 mm). The mean RENAL nephrometry score was 8.03 (range 4-10). The mean cold ischemic time (in clamped cases) was 25 min. The mean operative time was 193 min (range 113-310 min), and the mean estimated total blood loss was 172 mL (range 20-530 mL) in all cases. All operations were uneventful, and none required blood transfusion or conversion to nephrectomy. Postoperative complications, such as hemorrhage, urinary fistula formation and requirement of hemodialysis, were not observed. All patients had negative surgical margins, and were free of disease recurrence during the follow-up period (3-49 months). Overall, a remarkable decrease in renal function was not evident at the end of the follow-up period.
  
  
  CONCLUSIONS
  This new technique using soft coagulation appears to be safe and feasible for partial nephrectomy.
authors.affiliation: Department of Urology, Kameda Medical Center, Kamogawa, Chiba, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Ota
authors.forename: Hiroka
authors.initials: H
authors.lastname: Komori
authors.forename: Jyunryo
authors.initials: J
authors.lastname: Rii
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Ochi
authors.forename: Koichiro
authors.initials: K
authors.lastname: Suzuki
authors.forename: Naoki
authors.initials: N
authors.lastname: Shiga
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nishiyama
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D004564:Electrocoagulation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: partial nephrectomy; renal cell carcinoma; renorrhaphy; soft coagulation